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What I remember most about Mr. P. was the mix of fear and determination he carried — a man deeply wounded by years of trauma and substance use, yet still willing to trust the process enough to keep showing up.
Arrival and Presenting Issues
Mr. P., a 42-year-old gentleman, arrived at Siam Rehab Thailand in December 2023. He presented with several complex challenges, including severe cocaine and stimulant use disorder, severe alcohol use disorder, recurrent severe depression, severe anxiety, and a history of psychotraumas linked to military deployment.
He had been unemployed and placed on sick leave due to the severity of these issues. While he enjoyed a supportive relationship with his parents, he lived with his brother, who struggled with difficulties of his own.
Substance Use and Trauma History
Mr. P. had been using crack cocaine for more than 20 years and consuming alcohol daily for 25 years. His military service — 1.5 years of overseas deployment — left him with flashbacks, social anxiety, depression, stress, loneliness, and episodes of psychosis.
He had attempted recovery before, completing two inpatient admissions: one in 2018 (12 weeks) and another in 2022 (six weeks plus two months of aftercare). Unfortunately, he relapsed after both programs.
Commitment to Change
When he arrived at Siam Rehab, Mr. P. was desperate, anxious, and fearful, but he was also determined to make this attempt different. He committed to the six-week program, attending all therapeutic processes despite frequent emotional struggles. Over time, he began to trust me as his counselor.
In our one-to-one sessions, he showed openness and vulnerability, working through painful emotions while learning strategies to manage his negative feelings. With the support of staff and his peers, he began to feel less isolated in his struggle.
Program Extension and Breakthroughs
Recognizing the progress he was making and the work still ahead of him, Mr. P. applied for — and was granted — a four-week extension. These additional weeks gave him the opportunity to deepen his trust in himself and to develop the tools he needed to sustain recovery after leaving Thailand.
Life After Rehab
After completing a total of 10 weeks at Siam Rehab, Mr. P. returned home to live with his parents in a supportive environment. He also joined recovery fellowship groups and committed to his abstinent lifestyle.
We remain in regular contact, and he continues to share both his challenges and successes. As of today, he is still clean and sober, building a healthier and more stable life.
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